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MED 105- MEDICAL ETHICS > 13. PRIVACY AND CONFIDENTIALITY > Flashcards

13. PRIVACY AND CONFIDENTIALITY Flashcards

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USMLE® Step 1 flashcards
1
Q
  1. What are the 2 obligations when it comes to the Duty of Confidentiality?
A
  1. Moral Obligation
  2. Legal Obligation
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2
Q
  1. What is Moral Obligation?
A
  • the trust that exists in a doctor-patient relationship
    depends on confidentiality
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3
Q
  1. What is Legal Obligation?
A
  • information obtained throughout the course of a
    medical relationship should not be divulged
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4
Q
  1. What information should be kept confidential?
A
  • all the the patient’s identifiable information
  • this information can be written, computerised, audio
    recorded or kept in the memory of the doctor
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5
Q
  1. What information is included when we say: “all of the patient’s identifiable information”?
A
  1. CLINICAL INFORMATION
    - about the individual’s diagnosis or treatment
  2. IMAGES OF THE PATIENT
    - this can be in the form of a picture, photograph, video
    or audiotape
  3. WHO THE PATIENT’S DOCTOR IS
    • what clinics the patient attends
    • when the patient has appointments
  4. ANY OTHER INFORMATION THAT CAN IDENTIFY A
    PATIENT DIRECTLY
    - or indirectly
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6
Q
  1. Answer this question with 6 points.
A
  1. Patient Autonomy
  2. Virtue Ethics
  3. Consequentialism
  4. Rights and Privacy
  5. Implied Promise
  6. Trust
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7
Q
  1. What is meany by: “Patient Autonomy”?
A
  • this is the personal information that belongs to the
    patient

TO RESPECT THE PATIENT’S AUTONOMY:
- their information should not be disclosed without
consent

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8
Q
  1. What is meant by: “Virtue Ethics”?
A
  • a virtuous doctor should be sensitive
  • they should be responsible
  • they should be trustworthy
  • they should respect the patient’s confidences
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9
Q
  1. What is meant by: “Consequentialism”?
A

IF DOCTOR’S KEEP THE CONFIDENTIALITY:
- the patient’s trust the doctors
- the patient will be more likely to disclose important
information

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10
Q
  1. What is meany by: “Rights and Privacy”?
A
  • the patient has the right to decide who should have
    access to personal information
  • the patient has the right to authority over their pwn
    decisions

THE DOCTOR SHOULD BE ABLE TO DISTINGUISH:
- which personal information a patient wants to keep
secret
- AND which information the patient is willing to
disclose to others

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11
Q
  1. What is meant by: “Implied Promise”?
A
  • confidentiality is assumed in a doctor-patient
    relationship
  • breaking confidentiality breaks the promise that has
    been made to the patient
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12
Q
  1. What is meant by: “Trust”?
A
  • this is the precondition necessary for haring personal
    information
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13
Q
  1. What standards are an integral part of a Doctor-Patient relationship?
A
  • ethical standards
  • legal standards
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14
Q
  1. What are the 3 conditions that are needed to establish a Duty of Confidentiality?
A
  1. INFORMATION MUST HAVE AN INHERENT QUALITY OF
    CONFIDENTIALITY
    • this is obtained in medical practice
  2. INFORMATION THAT IS GIVEN IN CLINICAL CONTEXT
    - implies that there is an obligation to confidentiality
  3. UNAUTHORISED DISCLOSURE
    • will have consequences
    • it will cause some harm to the provider
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15
Q
  1. What is a limit of Confidentiality according to the World Medical Association? (WMA 2006)
A

CONFIDENTIALITY CAN BE BREACHED:
- when there is a real and imminent threat of harm
- to the patient or to others
- that can only be removed by disclosing confidential
information

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16
Q
  1. What are 5 legal frameworks regarding Confidentiality in the UK?
A
  1. Human Rights Act 1998
  2. Data Protection Act 1998
  3. Health and Social Care Act 2012
  4. Duty of Confidentiality under Law
  5. Notifiable Diseases and Public Health Legislations
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17
Q
  1. What is the Human Rights Act of 1998?
A
  • it revolves around the need for balance
  • it looks at the right to respect private and family life
  • it looks at the right to life and the right to freedom of
    expression
18
Q
  1. What is another act that works alongside the Data Protection Act of 1998?
A
  • the GDPR
  • the General Data Protection Regulation 2018
19
Q
  1. What are the GDPR and the Data Protection Act?
A
  • they are acts that control how personal information is
    used by organisations, businesses and the government
  • they keep data safe and secure
20
Q
  1. What is the Health and Social Care Act of 2012?
A
  • it is the regulation of patient information
21
Q
  1. What is the Duty of Confidentiality under Law?
A
  • this is the public interest in doctor’s and their
    maintenance of confidentiality
  • it is the public interest in protecting society or
    individuals from harm
22
Q
  1. What are 2 examples of Notifiable diseases and public health legislation?
A
  1. Public Health (Infectious Diseases) Regulations 1998
  2. Coronavirus Act 2020
23
Q
  1. Answer this question.
A
  • yes
  • the patient would need to give consent beforehand for
    the pictures to be used
  • this must be done even if the image is anonymised
  • the patient can be identified by this picture
24
Q
  1. Name 4 Secondary Uses of information?
A
  1. THE USE OF DATA IN MEDICAL RESEARCH
    - the data is anonymised
    - prior patient consent is still required
  2. CLINICAL AUDIT
    - this is often undertaken under the presumption of
    implied consent
  3. CONFERENCE PRESENTATIONS
    • this requires prior consent
  4. EDUCATIONAL PUBLICATIONS
    - this requires prior consent
25
Q
  1. In which situations is deliberately Confidentiality often breached?
A
  • in Routine Situations
26
Q
  1. What happens during Routine Situations?
A
  1. NURSES AND MEDICAL STUDENTS
    - can access the patient’s record
  2. THE USE OF INTERPRETERS
    • these facilitate communication when the doctor and
      patient do not speak the same language
  3. INFORMATION
    - that is shared with proxy-decision makers
  4. INFORMATION
    - that is shared with the family of the patient in critical
    care or a deceased patient
27
Q
  1. List 4 situations in which Patient Confidentiality can be accidentally breached?
A
  1. Lifts and Canteens
  2. A&E Department Wards
  3. Patient Notes
  4. Computers, Faxes and Printers
28
Q
  1. How can confidentiality be breached in Lifts and Canteens?
A
  • the patient’s information is discussed in crowded
    places
29
Q
  1. How can confidentiality be breached in A&E Department Wards?
A
  • there are many people in close proximity to the health
    care professionals
  • they discuss information regarding the patient
30
Q
  1. How can confidentiality be breached through the Patient’s Notes?
A
  • these notes can be left in an area with open access
  • they might be left on the receptionists desk
  • this allows other visitors and patients to see these
    notes
31
Q
  1. How can confidentiality be breached through Computers, Faxes and Printers?
A
  • the patient’s personal information can be seen on
    faxes and print-outs that have not been promptly filled
    in
  • the computer screen can be visible to the next patient
  • this screen has the details of the previous patient
32
Q
  1. List 3 statistics involving the accidental breaching of patient confidentiality?
A
  1. 13/113 LIFT JOURNEYS
    • consisted of hospital staff that made comments that
      compromised confidentiality
  2. DOCTORS MADE THE MOST COMMENTS
    • then allied health professionals
    • and then nurses
  3. MOST OF THE COMMENTS
    - referred to the patient’s by their initials
    - or by their reason for admission
    - names of the patients were used 4 times
33
Q
  1. What do most medical students have access to once they start their clinical training?
A
  • they have access to confidential information
34
Q
  1. What are the 4 aspects of confidentiality that Medical Students are bound to?
A
  1. The same rules as qualified doctors
  2. The students have access to confidential information
  3. The students have legal responsibilities with regards
    to treating confidentiality
  4. The accidental or minor breaches of confidentiality
35
Q
  1. Is this a breach of confidentiality?
A
  • yes
  • this is a minor breach of confidentiality
  • information was given that could have narrowed down
    the identification of the patient
36
Q
  1. What other source poses a potential risk of inadvertent breaches of the patient’s information?
A
  • Social Media and Networking Sites
  • these are used for personal and professional
    communication
37
Q
  1. What duty do Medical professionals and students have when it comes to social media?
A
  • they have to protect the patient’s confidentiality
  • they must be mindful to not disclose any identifying
    pieces of information
    (date, location, patient specific details)
38
Q
  1. How can Social media blur the boundary between private and public domains?
A
  • individual pieces of information can be taken in sum
  • these can help to identify a specific patient
  • this is a breach of confidentiality
  • the doctor can be accused of misconduct
39
Q
  1. In which 3 situations may confidentiality be legally and ethically breached?
A
  1. WHEN THE PATIENT GIVES CONSENT
    - this allows clinically relevant information to be shared
    with other staff members
    - the other staff members can now assist in the
    management of the patient
    - this information can also be shared with the patient’s
    family
  2. IN INSTANCES WHERE DOCTORS ARE REQUIRED TO
    BREACH CONFIDENTIALITY
  3. CIRCUMSTANCES WHERE THERE WOULD BE
    CONSIDERABLE DEFENCE
40
Q
  1. Does this summary make sense?
A
  • yes

MED 105- MEDICAL ETHICS (36 decks)

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